SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Bone Research
This article is part of the Research TopicRecent Advances in the Management of Osteoporosis: Prevention, Diagnosis and TreatmentView all 10 articles
High Salt Intake and Bone Health in Postmenopausal Women: Exposing the Lack of Studies – A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Department of Public Health, Nazarbayev University School of Medicine, Astana, Kazakhstan
- 2University of Pittsburgh School of Public Health, Pittsburgh, United States
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Introduction: Osteoporosis is a common health concern among women after menopause, partially due to declining estrogen levels, which are a major regulator of bone metabolism and calcium retention. This work presents the first systematic synthesis of evidence assessing the impact of dietary sodium intake on bone health among postmenopausal women. Although there is substantial research demonstrating that reducing sodium intake can lower urinary calcium excretion, much of this evidence has been derived from studies conducted in mixed populations, often without stratifying by age, sex, or hormonal status. Postmenopausal women, who are at increased risk for bone loss and calcium imbalance due to hormonal changes, remain significantly underrepresented in this body of literature. This research examines the impact of dietary salt on maintaining bone tissue structure and relates it to calcium excretion through urine as a marker of bone demineralization. Methods: A systematic review and meta-analysis were conducted in accordance with the guidelines for reporting systematic reviews. Systematic searching of four major databases, i.e., PubMed, EMBASE, Web of Science, and the Cochrane Library, was done to find reports of randomized controlled trials estimating the influence of sodium intake on calcium excretion in urine and on bone health indicators. Meta-analysis was used to synthesize evidence to estimate the effect of sodium intake on calcium excretion. Results: Six articles out of an initial 596 made it into the stringent selection criteria. The meta-analysis revealed that high sodium diets significantly increased urinary excretion of calcium in women after menopause, with a pooled mean difference of 29.38 mg/day (95% CI: 12.31 to 46.46, p < 0.01). These findings highlight the detrimental impact of excessive salt consumption on bone health, demonstrating a link between sodium consumption and accelerated loss of bone mass. Conclusion: Based on the findings of the review, limiting dietary sodium consumption is recommended as a way to help prevent osteoporosis in postmenopausal women.
Keywords: Sodium intake, High salt intake, Dietary salt, Urinary calcium excretion, calcium loss, Bone health, postmenopausal women, Osteoporosis risk
Received: 28 Aug 2025; Accepted: 28 Oct 2025.
Copyright: © 2025 Imash, Gusmanov and Chan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mei-Yen Chan, yen.chan@nu.edu.kz
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